MG TNA-Peri

Per 100 mL: 11% chamber 1 Glucose 61.5 mL, glucose monohydrate 7.44 g. 11.3% chamber 2 Amino acid 20.8 mL, L-alanine 0.33 g, L-arginine 0.24 g, L-aspartic acid 0.071 g, L-glutamic acid 0.12 g, glycine 0.16 g, L-histidine 0.14 g, L-isoleucine 0.12 g, L-leucine 0.16 g, L-lysine HCl 0.24 g, L-methionine 0.12 g, L-phenylalanine 0.16 g, L-proline 0.14 g, L-serine 0.094 g, L-threonine 0.12 g, L-tryptophan 0.04 g, L-tyrosine 0.005 g, L-valine 0.15 g, Ca chloride hydrate 0.02 g, Na glycerophosphate hydrate 0.1 g, Mg sulfate hydrate 0.07 g, KCl 0.12 g, Na acetate hydrate 0.17 g. 20% chamber 3 Fat emulsion 17.7 mL, purified soybean oil 3.54 g, purified yolk phospholipid 0.21 g, glycerol 0.39 g

Supply of water, electrolytes, amino acids & calories to patients by TPN when oral or enteral nutrition is unfeasible, insufficient or contraindicated.

IV drip infusion Generally 27-40 mL/kg [equiv to amino acid 0.7-1 g/kg daily (nitrogen 0.1-0.15 g/kg)] into peripheral or central veins. Adult Individualized dosage. Normal nutritional state or mild catabolic stresses Amino acid 0.7-1 g/kg (nitrogen 0.1-0.15 g/kg) daily. Moderate to high catabolic stresses Amino acid 1-2 g/kg (nitrogen 0.15-0.3 g/kg). Administration rate: Should not exceed 3.7 mL/kg/hr (equiv to glucose 0.25 g/kg, amino acid 0.09 g/kg, lipid 0.13 g/kg). Infusion period: 12-24 hr. Childn 2-10 yr 14-28 mL/kg, may increase by 10-15 mL/kg/day. Max: 40 mL/kg/day.

Hypersensitivity to eggs & soy protein. Hyperlipemia, severe liver insufficiency & blood coagulation disorders, congenital disorder of amino acid metabolism, severe renal insufficiency w/o hemofiltration or dialysis, acute shock, hyperglycemia requiring insulin over 6 u hrly, elevated serum levels including electrolytes. Acute pulmonary edema, hyperhydration, decompensated heart failure, hypotonic dehydration; hemophagocytotic syndrome; unstable conditions (eg, severe post-traumatic conditions, decompensated diabetes, acute MI, metabolic acidosis, severe sepsis, hyperosmolar coma). Hypokalemia, patients w/ existing or history of MI. Neonates or infants <2 yr.

Interrupt use immediately if any signs/symptoms of anaphylactic reaction or abnormal signs occurs. Lipid metabolism disorders induced by renal failure, pancreatitis, impaired liver function, hypothyroidism (accompanied by hypertriglyceridemia), sepsis. Lactic acidosis, insufficient cellular oxygen supply, increased serum osmolarity, patients who need fluid resuscitation. Patients w/ tendency toward electrolyte retention. Correct electrolyte imbalance prior to initial administration. Increased risk of infection for central venous inj. Serum triglyceride should not exceed 2 mmol/L 5-6 hr after administration. Consider additional administration of trace elements eg, copper, Zn in case of long-term administration. False coagulation reaction. Monitor serum glucose level, electrolytes, osmolarity, fluid balance, acid-base status, liver enzyme level (alkaline phosphatase, ALT, AST), CBC & coagulation during administration. Renal failure. May interfere lab measurements eg, bilirubin, lactate dehydrogenase, oxygen saturation, Hb. Malnourished patients. Pregnancy & lactation. Elderly.

Elevated body temp or induced shivering, chillness, nausea/vomiting; increased liver enzyme activities; thrombophlebitis; hypersensitivity reactions (eg, anaphylactic reaction, rash, urticaria), resp symptoms (hyperventilation), hyper/hypotension; hemolysis, increased reticulocytes, abdominal pain, headache, fatigue, penile stiffness. Excessive administration: hyperlipidemia, fever, fatty infiltration, hepatomegaly, megalosplenia, anemia, leukocytopenia, thrombocytopenia, blood agglutination disorder, coma.

May interfere lipase system w/ insulin. Increased plasma lipolysis accompanied by decreased triglyceride clearance rate w/ heparin. May interfere therapeutic effect of coumarin derivatives. May precipitate when mixed w/ acidic soln.

Parenteral Nutritional Products

B05BA - Solutions for parenteral nutrition ; Used in I.V. solutions.

Rx